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Home My WebLink About14301-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. Z14301 Date ..... March 24 ................. · ........................... 19 86 · o o THIS CERTIFIES that the building Addition Location of Property 2575 Old North Road Southold h[~{~s~ hio[ ................ '$'~i ....... Hamlet County Tax Map No. 1000 Section . . 0..5.5 ....... Block ... 0..1 .......... Lot .. 0. 9 .3...2. ......... Subdivision ............ .X. ................. Filed Map No ......... Lot No .............. conforms substantially to the Application for Building Permit heretofore fried in this office dated · · .S.el:?t. -' ..... .5 ....... ,19.8.5. pursuant to which Building Permit No... 14301Z dat~ .....S.e.p..t: ..... .2.3 ........... 19 .8.5. ,was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ......... .... Construct a Garage Addition to Existing Dwelling -.-- The certificate is issued to BOUNATSOS ¢ MR. & MRS. ANGELOS ................ ro~,.er,/~/fi,i~) ...................... of the aforesaid building. Suffolk County Department of Health Approval .N./..R. UNDERWRITERS CERTIFICATE NO. N/R. Building Inspector Rev. 1/81 FOB~ NO. fi TO~VN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. ¥. BUILDING PERMIT CFHIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLL=TION OF THE WORK AUTHORIZED) 14301 Z Permission is hereby granted t~ ~;~.~.....~....v.~ ............ ....~.~~.....~.:~.,....t.t.~.~./. ........ ~..~.~.:.....~.....~.~.....~~....~...~.~.....~. -, .,-, · -, ,,~ .,-, , ,-,.,, ,-~......~..~..~.:,...~......~,~,~....~,,~ ...................................... : .................. '' ' ~-- "" /~--°b/ J ..... at premises located c~t ..m~.~...~...~. ........ ¢~;~.....~...:L~., ........ ~.~ .................. County Tax Map No. I000 Section ..... ..(~....~.... ...... Block ...... .(~.l .......... Lot No ...... ,'~:.~..,: ...... ~,ursuont ,o...~.=,o. ~ .... ~~.,....~ .............. . ,d~ ~.~ ~.~.o~ ~ ,~ Building Inspector. Building Inspector Rev. 6/30/80 FORM NO. 6 TOWN OF SOUTHOLD Building Department Town Hall Southold, N.Y. 11971 APPLICATION FOR CERTIFICATE OF OCCUPANCY Instructions This application must be filled in typewriter OR ink, and submitted in duplicate to the Building Inspec- tor with the following; for new buildings or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final approvat of Health Dept. of water supply and sewerage disposal-(S-9 form or equal). 3. Approval of electrical installation from Board of Fire Underwriters. 4. Commercial buildings, Industrial buildings, Multiple Residences and similar buildings and installa- tions, a certificate of Code compliance from the Architect or Engineer responsible for the building. 5. Submit Planning Board approval of completed site plan requirements where applicable, For existing buildings (prior to April 1957), Non-conforming uses, or buildings and "pre-existing" land usesi 1. Accurate survey of peoperty showing all property lines; streets, buildings, and unusual natural or topographic featu res. 2. Sworn statement of owner or previous owner as to use, occupancy and condition of buildings. 3. Date of any housing code or safety inspection of buildings or premises, or other pertinent informa- tion required to prepare a certificate. Fees: 1. Certificate of occupancy $5.00 2. Certificate of occupancy on pre-existing dwelling or land use 3. Copy of certificate of occupancy $1.00 $5.00 Date. ?. / .//./2~..~. ............ New Building ....//~........ Old or Pre-existing Building ............ Vacant Land ............. Location of Property ~2,5 O f~ ~'~ House No. Street Hamlet Owner or Owners of Property . ./'~..~.. ~d...~../7,$...~...~.~.¢./.°. ,5....~..o..~..r'/..~..~...?.'.0...~. ........... County Tax Map No. 1000 Section O~--~ Block ~ ! Lot. Subdivision ................................. Filed Map No ........... Lot No .............. Permit No.l.~..~.0. ?. '.~, Date of Permit~.j~.g/.~.~..Applicant .~.~'.q ~(.~: z...~.~., ~. ?..I-.~/ ....... ~ Approval Health Dept. Approval ........................ Labor Dept ......................... Underwriters Approval ... -- Planning Board Approval ~ Request for Temporary Certificate ~ Final Certificate ~ Fee Submitted $ ~,~. ¢ .~. L~. ................... Construction on above described building and [~it~rneets all applicable codes and regulations. ~ -~_~G'~- Applicant .................... Rev. 10-10-78 FOR EESPOt,!SIBUE ~ FQR , qS~RUC~' 'iELD INS~ECTION COMMENTS ~OUNDATION (lst}~ UNDATION (2nd) ~UGH FRAME & PLUMBING NSULATION PER N. STATE ENERGY CODE FINAL ADDITIONAL COMMENTS: ' FORM NO. 1 , TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL ,~OUTHOLD, N.Y. 11971 TEL.: 765-1803 Examined .~..~..'~....h'AH...~..~., 19 Approved . .~. ~ .~?...~.~. ,, 19~.5. Permit No./.q.5.9.I. .~... Disapproved a/c ..................................... Received ........... ,19... (Building Inspector) APPLICATION FOR BUILDING PERMIT INSTRUCTIONS a. This application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with 3 ~ts of plans, accurate plot plan to scale. Fee according to schedule. b, Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets ,r areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli- ation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit hall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy hall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Btfilding Permit pursuant to the uilding Zone Ordinance of the Town of Southold, Snffolk County, New York, and other applicable Laws, Ordinances or .egulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. he applicant agrees to comply with ail applicable laws, ordinances,.bu~ding code, housing code, and regulations, and to tmit authorized inspectors on premises and in building for necessary ingbe~tions. .... ........ ;... .... · (Signature of applicant, or name, if a corpora ion) ~ (Mailing address of applicant) £ate whether applicant is owner, lessee, agent, architect, engineer, general, contractor, electrician, plumber or builder. ~e'~ ~;ne; of premises..,~/~..~...~./~...d (a~s c~h~a.x ~c.,~t?,.t~f~)~- ....................... 'applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No ...... /./,~. · .............. Plumber's License No ......................... Electrician's License No ....................... Other Trade's License No ...................... Locatinnoflandonwhiohproposedworkw lbedone.... . z. 7...o./J House Number Street Hamlet County Tax Map No. 1000 Section ................. ~ Block ................. ~ ~/ Lot ................... ~ ~-- ~ Subdivision ................... ~ ................ Filed Map No ............... Lof ~.~ ......... (Nme) State existing use and occupancy of premises and intended use and occupancy of proposed construction: a. Existing use and occupancy ..... 6 ~ " ' ........... 3. Nature of work (check which appiicable): New Building ......... Addition ........ Alteration .......... Repair .............. Remov31 .............. Demolition .............. Other Work ............. ,.. ' ~l~,e~.-~ 0~ (Description) (to be paid on filing this application) 5. If dwelling, number of dwelling uhits / Number of dwelling units on each floor ..... / If garage, number of cars .... /.i .................................................................. 6. If business commercial or mixed ~occupancy, specify nature and extent of each tyne of use 7. Dimensmns o.f existing structures if any Front ....~. ~. .. Rear ~h~t~' Denth Height .~ .......... Number of Stories ~ ..... ~.7..~.71 ............... Dimensions of same structure with alterations or additions'. Front ..~.¢.... .... . ... Rear ...~. ~.... ~ .. . . ... D~,pth ...................... Height ........ ~ ............ Number of Stories ......... ! ........ .8, Dimensions of entire new construction: Front .t~..~ .......... Rear..~. ~../ ......... Depth .~ .......... Height ~..G~..~. of Stones .................................... t' ................ 10 Date of Purchase ~ Name of Former Owner 11. zone o~ use district in which premises are situated..__~.~. / .............................................. 12. Does proposed construction violate any zoning law, ordinance or regulation: J~/~5~ ............................ Name of Architect ..... : :. ·. iT. ~ ............. Address .... ~ ........... Phone No.. ~ ......... PLOT DIAGRAM. Locate clearly and distinctly all Ibuildh~gs, whether existing or p~oposed, and~indicate all set-back dimensions from property lings. Give street and block ~umber or description according to deed, and show street names and indicate whether interior or corner lot. STATE OF NEW YORK, ' S.S COUNTY O~F; ........ ~ ..... ,, ..... ,~...........'e~ .................... being duly sworn, deposes and says that he is the applicant (Name of individual ~t~ning contract) above named· He is the '"' (Contractor, agent, corporate officer, etc.) of said owner or owners, ~d is duly author~ed to perform or have perfomed the said work and to m~e ~d file ~is application; that all statements con~ned ~ this application are true to the best of his ~owledge and belief; and that the work will be perfo~ed in the m~n~r set forth in the application filed therewith. Sworn to before me this ........................ day. qf... v ..... ,19